CORPORATE REGISTRATION

FORM
Date of application: ____________________

COMPANY DETAIL
Name of Entity
Company Name
Company Address/Headquarter

City/State/Zip
Phone Alt Phone
Corporate Email

NATURE OF BUSINESS / SHORT COMPANY INTRO

1. -Legal Entity and Ownership. Describe the ownership and legal establishment of the company. ...
2. -Identify Your Type of Business. ...
3. -Describe Your Business Operations.

PERSON IN CHARGE - CONTACT

Name
Title
Phone Number Work Phone
Email

PT. Trinusa Travelindo

Menara Citicon, 2nd Floor – Menara Citicon, Jl. Letjend
S.Parman Kav 72, Slipi, 11410, DKI Jakarta
Corporate@traveloka.com
 CORPORATE REGISTRATION
FORM

PERSON IN CHARGE - CONTACT

Director Name (PIC with
Authority to Sign the
Agreement)
Title

PAYMENT CONTACT

Account Payable Name

Title
Phone Number Work Phone
Email (for sending e invoice,
could be more than 1 email)

USER ID / CORPORATE ACCOUNT

Account 1 (email)
Account 2 (email)
This email will be registered as administrator user role to have corporate booking access

PAYMENT PROPOSAL
Billing Method Invoicing
Service Fee 3,5%
Billing Cycle & TOP Bi-Weekly & 15 days
Proposed Credit Limit
Proposed credit limit will be assessed based on audited financial report or last 6-month bank statement

PT. Trinusa Travelindo

Menara Citicon, 2nd Floor – Menara Citicon, Jl. Letjend
S.Parman Kav 72, Slipi, 11410, DKI Jakarta
Corporate@traveloka.com
 CORPORATE REGISTRATION
FORM

Company Business Partner Data

Company 1

Name of Company

Business Relation [Supplier / Distributor / etc.)

Name of PIC

Email of PIC

Office Phone (ext.) /

Handphone

Company 2

Name of Company

Business Relation [Supplier / Distributor / etc.)

Name of PIC

Email of PIC

Office Phone (ext.) /

PT. Trinusa Travelindo

Menara Citicon, 2nd Floor – Menara Citicon, Jl. Letjend
S.Parman Kav 72, Slipi, 11410, DKI Jakarta
Corporate@traveloka.com
 CORPORATE REGISTRATION
FORM
Handphone

Document Checklist*

Initial Registration Form

Article of association of the company and the amendment /

Akta Pendirian & Perubahan

Company Tax Registration Card / NPWP

ID Card of the PIC with Attorney / Director | fotokopi KTP PIC

yang memiliki kuasa / Direksi sesuai akta

Operating License/Permit (SIUP & TDP)/NIB

Financial Data (Audited Financial Statement previous year &

current year) / Last 6 Months Bank Statement

PKP / Non PKP Statement | Keterangan PKP / Non PKP

CREDIT ASSESSMENT REQUIREMENT (Mandatory)

1. Laporan Keuangan 1 tahun terakhir yang sudah diaudit dan tahun berjalan
2. Rekening Koran 6 Bulan Terakhir

*choose 1 (one) from above options

PT. Trinusa Travelindo

Menara Citicon, 2nd Floor – Menara Citicon, Jl. Letjend
S.Parman Kav 72, Slipi, 11410, DKI Jakarta
Corporate@traveloka.com
 CORPORATE REGISTRATION
FORM

In connection with the application for registration of our Corporate program I hereby declare on behalf of the Company as
follows:

1. That all information in the application of this corporate program I have filled in completely and truthfully.
2. Authorize PT Trinusa Travelindo or any other party affiliated with PT Trinusa Travelindo to obtain references from
any source and in a manner deemed appropriate including from the Credit Management Information Institution
associated with the Company and parties listed on this form, including but not limited to information concerning
identity, credit, employment, income, fulfillment of other obligations, and other information which may reflect the
ability to fulfill obligations.
3. If my application is approved, I will submit and be bound by the terms and conditions issued by PT Trinusa
Travelindo.
4. PT Trinusa Travelindo shall be entitled and authorized to refuse or approve all or part of this application without
giving reason for it based on analysis of PT Trinusa Travelindo.
5. Hereby I and also the parties listed above release PT Trinusa Travelindo, and other parties affiliated with PT
Trinusa Travelindo of any legal liability and consequences arising from the acquisition of company information and
the parties listed above relating to the submission of program registration.

Applicant

Sign here:

Name:

Position:

Phone:

PT. Trinusa Travelindo

Menara Citicon, 2nd Floor – Menara Citicon, Jl. Letjend
S.Parman Kav 72, Slipi, 11410, DKI Jakarta
Corporate@traveloka.com